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Background Patients with inflammatory bowel disease (IBD) have attenuated responses to current vaccinations. There is a limited body of evidence suggesting patients with IBD receiving TNF antagonists have an attenuated response to vaccination against COVID-19. We sought to determine the impact of IBD and various medications for the treatment of IBD on antibody responses to vaccination against COVID-19. Methods Patients with IBD (n=270) and healthy controls (HC, n=116) were recruited prospectively and quantitative antibody responses were assessed following 1st and 2nd doses of COVID-19 vaccination. The impact of IBD and medications for treatment of IBD on vaccine response rates was investigated. Results All HC seroconverted post complete vaccination [100%]. A small proportion of patients with IBD failed to seroconvert [2%]. Median IgG spike protein (SP) antibody levels post-complete vaccination in our IBD cohort was significantly lower than HC [2,613 AU/mL versus 6,871 AU/mL, p= Conclusion Patients with IBD who do not seroconvert post-vaccination against COVID-19 are a vulnerable cohort. Patient with IBD have attenuated serological responses to SARS-CoV-2 vaccination. Use of anti-TNF therapy further impacts IgG SP antibody levels. Impaired response to vaccination in our study highlights the importance of booster vaccination programmes for patients with IBD.

Background Caudal-related homeobox transcription factor 2 (CDX2) is an intestine-specific transcription factor implicated in tumour differentiation, proliferation, cell adhesion and migration. Negative CDX2 status (CDX2-) is associated with worse prognosis in colorectal cancer and may identify high-risk stage II disease that benefits from adjuvant chemotherapy. This observational study investigated whether CDX2- is associated with prognosis or response to chemotherapy in the mismatch repair-deficient (dMMR) phenotype of colorectal cancer. Methods Patients with resectable dMMR colorectal cancer were eligible for inclusion. The prognostic and predictive value of CDX2 expression on the presence of lymph node metastasis (LNM) and survival was investigated. CDX2 status was determined via immunohistochemistry using the Leica Bond™ CDX2 (clone EP25) ready-to-use primary antibody. Results Some 235 of 238 consecutive dMMR tumours were assessed for CDX2 status. CDX2- was observed in 15·7 per cent of colorectal cancer. Interobserver agreement was excellent (κ = 0·863; P

Background Caudal‐related homeobox transcription factor 2 (CDX2) is an intestine‐specific transcription factor implicated in tumour differentiation, proliferation, cell adhesion and migration. Negative CDX2 status (CDX2−) is associated with worse prognosis in colorectal cancer and may identify high‐risk stage II disease that benefits from adjuvant chemotherapy. This observational study investigated whether CDX2− is associated with prognosis or response to chemotherapy in the mismatch repair‐deficient (dMMR) phenotype of colorectal cancer. Methods Patients with resectable dMMR colorectal cancer were eligible for inclusion. The prognostic and predictive value of CDX2 expression on the presence of lymph node metastasis (LNM) and survival was investigated. CDX2 status was determined via immunohistochemistry using the Leica Bond™ CDX2 (clone EP25) ready‐to‐use primary antibody. Results Some 235 of 238 consecutive dMMR tumours were assessed for CDX2 status. CDX2− was observed in 15·7 per cent of colorectal cancer. Interobserver agreement was excellent (κ = 0·863; P

Gene-specific possibilities

At both the international and domestic level, the existence of a right to education is given widespread support. But what are the content and consequences of this right? The meaning of the right to education was examined recently in the context of special education by the High Court and Court of Appeal in Daniels v Attorney-General. The High Court saw the right as a substantive one; the Court of Appeal viewed it in procedural terms. These different conceptions of the right affected the remedies available to the plaintiffs. This article assesses the competing understandings of the education right in NZ, and concludes, particularly in light of the House of Lords' decision in Phelps v Hillingdon London Borough Council, that the High Court's approach is to be preferred.

Dendritic cells (DCs) are likely to play a key role in the compromised T-cell function associated with hepatitis C Virus (HCV) infection. However, studies of DC function in HCV-infected patients to date have yielded conflicting findings possibly because of patient and virus heterogeneity. Here, we report the characterization of monocyte-derived DCs obtained from a homogenous cohort of women who were infected with HCV genotype 1b following exposure to contaminated anti-D immunoglobulin from a single donor source. Patients included in the study had not received anti-viral therapy and all had mild liver disease. We show that phenotypically normal monocyte-derived dendritic cells (MDDCs) (CD11c(+) HLA(-) DR(+) CD1a(+) CD14(lo) ) can be obtained from these patients. These cells respond to both Poly(I:C) and LPS, by up-regulating expression of CD86. They secrete high levels of IL-8 and CCL5 in response to LPS, an indication that the MyD88-dependent and MyD88-independent signalling pathways downstream of TLR4 ligation are functioning normally. However, these cells are poor stimulators of T-cell proliferation in allogeneic mixed lymphocyte reactions. Furthermore, patient MDDCs fail to secrete IFN-α in response to poly(I:C) or IFN-β stimulation. Altered DC function may contribute to impaired cellular immune responses and chronicity of disease following HCV infection in this cohort. An effective therapeutic vaccine for chronic HCV infection will most likely need to target DCs to elicit an appropriate cellular response; therefore, it is important to resolve how the DCs of different patient cohorts respond to stimulation via TLRs.

Proprioception following lower extremity injuries is commonly recommended, but there is little information on proprioception training following upper extremity injuries. No studies have evaluated whether proprioception programs for athletes in open kinetic chain activities (throwing, shot putting) should be different than programs for athletes in closed kinetic chain activities (gymnastics, swimming, kayaking, or rowing). In this paper, we provide a rationale for proprioception training for upper extremity injuries in athletes and the importance of analyzing the athlete's sport and activity for specificity of proprioception exercises. We then discuss one popular proprioception exercise, rhythmic stabilization, and propose several additional upper extremity proprioception exercises, along with instructions for the athletic trainer on how to direct the athlete through these exercises.

Thesis: Successful implementation of C4I For The Warrior (C4IFTW) is dependent upon overcoming technical issues, budgetary constraints, and lack of cooperation between the armed services. This paper examines past, present and future technologies involved with the C4IFTW concept. USMC, Command and control, C2, C3, C4I, Joint command and control, C4IFTW, JITC, CIM, DISA, Defense ADP, Data standards, Interoperability.

We examined the incidence of health problems in elite-level amateur boxing athletes who sparred, trained, or competed at the United States Olympic Training Center in Colorado Springs, Colorado from January 1, 1977 through June 30, 1992. We think this is the first study to examine both injuries and illnesses in a population of elite-level athletes. We collected data on 1,776 reported problems (1219 injuries, 557 illnesses) from standard medical report forms completed by the permanent and volunteer sports medicine staff. We classified the information based on type, body region, location, description, and occurrence. There were significant differences between the frequency of injuries and illnesses and between the classifications and regions for each type of problem. Collectively, serious injuries represented only a relatively small percentage (6.1%) of all problems. We concluded that illnesses comprised a small but important portion of problems, that most illnesses involved respiratory tract infections (71%), that there is only a small risk for serious injury, and that injuries occur in a hierarchy of upper extremity (441, 25%), head/face (344, 19%), lower extremity (267, 15%), and spinal column (167, 9%) for amateur boxers.

The purpose of this study was to use a qualitative research technique and define problems faced by one hospital that was attempting to increase demand for its emergency services. A telephone survey of 450 affluent and well-educated suburban residents was conducted to determine their perceptions of six major facilities. Topics included actual and preferred facility use by injury type, general perceptions concerning staff and facility, and other components of service quality. Results indicated that a variety of sociological, psychological, environmental, and situational factors interacted when the respondents formed attitudes concerning hospital emergency use and service. They were often uncertain of their real attitudes and conveyed varying opinions about the desirability or effectiveness of similar services. Health care providers should note these differences and modify the marketing mixes in a manner that best conveys their unit's competitive advantages. They could also benefit from using the qualitative research technique described in this paper and from adopting the marketing concept.

THE PURPOSE in this clinical investigation was to II study and to compare the effects of the administration of various gonadotropins upon human spermatogenesis and urinary androgen excretion. The materials used in the survey consisted of chorionic gonadotropin, to be designated as APL, pregnant mare serum derivative (PMS), and anterior pituitary extract (AP), which contains primarily the gonadotropic element, as stated by the manufacturer. The subjects comprised 14 male patients, for whom repeated examinations of semen and repeated assays of urinary androgens, either one or both, were done during the period of investigation. The presenting symptoms and final diagnoses varied in these cases, and will be discussed subsequently. Since gonadotropic response in the human so often differs from that found in animal experimentation, and because the effects in animals are generally well known, we shall confine our review of the literature to a partial survey of reported clinical findings.

Desoxycorticosterone acetate is one of several synthetic adrenal cortical hormones. It was produced by Steiger and Reichstein 1 and announced in 1937. More recently, its existence in beef adrenals has been shown by Reichstein and von Euw. 2 Reports dealing with the clinical use of this material have been published by Levy-Simpson, 3 Levy-Simpson, Wilkinson, Himsworth and Jones, 4 Cleghorn, Fowler and Wenzel, 5 Thorn, Howard and Emerson 6 and Zahler and Litzka. 7 Corticosterone is apparently identical with Kendall's 8 substance B. We have treated six cases of Addison's disease with this material for periods ranging from six to ten months. Except for brief periods of observation, such treatment has been combined with the use of sodium chloride as enteric coated tablets, in doses varying from 3 to 16 Gm. per day. 9 At first potassium intake was limited in all cases, 10 but more recently strict dietary restrictions

Excerpt CASE REPORT The patient was a Jewish woman, 48 years of age. Her symptoms appeared in 1905 when she was 29 and in her second pregnancy. At that time, she had the first of a long series of a...